Acute changes in a respiratory inflammation marker in guards following Beijing air pollution controls

The Association Between Personal Air Pollution Exposures and Fractional Exhaled Nitric Oxide (FeNO): A Systematic Review

PURPOSE OF REVIEW

Airway inflammation is a common biological response to many types of environmental exposures and can lead to increased nitric oxide (NO) concentrations in exhaled breath. In recent years, several studies have evaluated airway inflammation using fractional exhaled nitric oxide (FeNO) as a biomarker of exposures to a range of air pollutants. This systematic review aims to summarize the studies that collected personal-level air pollution data to assess the air pollution-induced FeNO responses and to determine if utilizing personal-level data resulted in an improved characterization of the relationship between air pollution exposures and FeNO compared to using only ambient air pollution exposure data.

RECENT FINDINGS

Thirty-six eligible studies were identified. Overall, the studies included in this review establish that an increase in personal exposure to particulate and gaseous air pollutants can significantly increase FeNO. Nine out of the 12 studies reported statistically significant FeNO increases with increasing personal PM2.5 exposures, and up to 11.5% increase in FeNO per IQR increase in exposure has also been reported between FeNO and exposure to gas-phase pollutants, such as ozone, NO2, and benzene. Furthermore, factors such as chronic respiratory diseases, allergies, and medication use were found to be effect modifiers for air pollution-induced FeNO responses. About half of the studies that compared the effect estimates using both personal and ambient air pollution exposure methods reported that only personal exposure yielded significant associations with FeNO response. The evidence from the reviewed studies confirms that FeNO is a sensitive biomarker for air pollutant-induced airway inflammation. Personal air pollution exposure assessment is recommended to accurately assess the air pollution-induced FeNO responses. Furthermore, comprehensive adjustments for the potential confounding factors including the personal exposures of the co-pollutants, respiratory disease status, allergy status, and usage of medications for asthma and allergies are recommended while assessing the air pollution-induced FeNO responses.

Impact of Beijing's "Coal to Electricity" program on ambient PM2.5 and the associated reactive oxygen species (ROS)

The Beijing "Coal to Electricity" program provides a unique opportunity to explore air quality impacts by replacing residential coal burning with electrical appliances. In this study, the atmospheric ROS (Gas-phase ROS and Particle-phase ROS, abbreviated to G-ROS and P-ROS) were measured by an online instrument in parallel with concurrent PM_2.5 sample collections analyzed for chemical composition and cellular ROS in a baseline year (Coal Use Year-CUY) and the first year following implementation of the "Coal to Electricity" program (Coal Ban Year-CBY). The results showed PM_2.5 concentrations had no significant difference between the two sampling periods, but the activities of G-ROS, P-ROS, and cellular ROS in CBY were 8.72 nmol H₂O₂/m³, 9.82 nmol H₂O₂/m³, and 2045.75 µg UD /mg PM higher than in CUY. Six sources were identified by factor-analysis from the chemical components of PM_2.5. Secondary sources (SECs) were the dominant source of PM_2.5 in the two periods, with 15.90% higher contribution in CBY than in CUY. Industrial Emission & Coal Combustion sources (Ind. & CCs), mainly from regional transport, also increased significantly in CBY. The contributions of Aged Sea Salt & Residential Burning sources to PM_2.5 decreased 5.31% from CUY to CBY. The correlation results illustrated that Ind. & CCs had significant positive correlations with atmospheric ROS, and SECs significantly associated with cellular ROS, especially nitrates (r = 0.626, p = 0.000). Therefore, the implementation of the "Coal to Electricity" program reduced PM_2.5 contributions from coal and biomass combustion, but had little effect on the improvement of atmospheric and cellular ROS.

Estimation of health risk and economic loss attributable to PM2.5 and O3 pollution in Jilin Province, China

Ambient pollutants, particularly fine particulate matter (PM2.5) and ozone (O3), pose significant risks to both public health and economic development. In recent years, PM2.5 concentration in China has decreased significantly, whereas that of O3 has increased rapidly, leading to considerable health risks. In this study, a generalized additive model was employed to establish the relationship of PM2.5 and O3 exposure with non-accidental mortality across 17 districts and counties in Jilin Province, China, over 2015-2016. The health burden and economic losses attributable to PM2.5 and O3 were assessed using high-resolution satellite and population data. According to the results, per 10 µg/m3 increase in PM2.5 and O3 concentrations related to an overall relative risk (95% confidence interval) of 1.004 (1.001-1.007) and 1.009 (1.005-1.012), respectively. In general, the spatial distribution of mortality and economic losses was uneven. Throughout the study period, a total of 23,051.274 mortalities and 27,825.015 million Chinese Yuan (CNY) in economic losses were attributed to O3 exposure, which considerably surpassing the 5,450.716 mortalities and 6,553,780 million CNY in economic losses attributed to PM2.5 exposure. The O3-related health risks and economic losses increased by 3.75% and 9.3% from 2015 to 2016, while those linked to PM2.5 decreased by 23.33% and 18.7%. Sensitivity analysis results indicated that changes in pollutant concentrations were the major factors affecting mortality rather than baseline mortality and population.

Quantitative estimation of meteorological impacts and the COVID-19 lockdown reductions on NO2 and PM2.5 over the Beijing area using Generalized Additive Models (GAM)

Unprecedented travel restrictions due to the COVID-19 pandemic caused remarkable reductions in anthropogenic emissions, however, the Beijing area still experienced extreme haze pollution even under the strict COVID-19 controls. Generalized Additive Models (GAM) were developed with respect to inter-annual variations, seasonal cycles, holiday effects, diurnal profile, and the non-linear influences of meteorological factors to quantitatively differentiate the lockdown effects and meteorology impacts on concentrations of nitrogen dioxide (NO2) and fine particulate matters (PM2.5) at 34 sites in the Beijing area. The results revealed that lockdown measures caused large reductions while meteorology offset a large fraction of the decrease in surface concentrations. GAM estimates showed that in February, the control measures led to average NO2 reductions of 19 μg/m3 and average PM2.5 reductions of 12 μg/m3. At the same time, meteorology was estimated to contribute about 12 μg/m3 increase in NO2, thereby offsetting most of the reductions as well as an increase of 30 μg/m3 in PM2.5, thereby resulting in concentrations higher than the average PM2.5 concentrations during the lockdown. At the beginning of the lockdown period, the boundary layer height was the dominant factor contributing to a 17% increase in NO2 while humid condition was the dominant factor for PM2.5 concentrations leading to an increase of 65% relative to the baseline level. Estimated NO2 emissions declined by 42% at the start of the lockdown, after which the emissions gradually increased with the increase of traffic volumes. The diurnal patterns from the models showed that the peak of vehicular traffic occurred from about 12pm to 5pm daily during the strictest control periods. This study provides insights for quantifying the changes in air quality due to the lockdowns by accounting for meteorological variability and providing a reference in evaluating the effectiveness of control measures, thereby contributing to air quality mitigation policies.

Ambient PM2.5 exposure and hospital cost and length of hospital stay for respiratory diseases in 11 cities in Shanxi Province, China

BACKGROUND

Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) on hospital cost and length of hospital stay for respiratory diseases in China.

METHODS

We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM2.5 using the standards of WHO (25 µg/m3) and China (75 µg/m3) as reference.

RESULTS

Each 10 µg/m3 increase in lag03 PM2.5 corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM2.5 exposures using WHO's guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case.

CONCLUSION

Significant respiratory burden could be attributable to PM2.5 exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.

PM2.5-induced pulmonary inflammation via activating of the NLRP3/caspase-1 signaling pathway

Particulate matter 2.5 (PM2.5)-induced pulmonary inflammation has become a public concern in recent years. In which, the activation of the NLRP3/caspase-1 pathway was closely related to the inflammatory response of various diseases. However, the promotion effect of the NLRP3/caspase-1 pathway on PM2.5-induced pulmonary inflammation remains largely unclear. Here, our data showed that PM2.5 exposure caused lung injury in the mice by which inflammatory cell infiltration occurred in lung and alveolar structure disorder. Meanwhile, the exposure of human bronchial epithelial cells (16HBE) to PM2.5 resulted in suppressed cell viability, as well as elevated cell apoptosis. Moreover, a higher level of inflammatory cytokine and activation of the NLRP3/caspase-1 pathway in PM2.5-induced inflammation mice models and 16HBE cells. Mechanistically, pretreatment with MCC950, a NLRP3/caspase-1 pathway inhibitor, prevented PM2.5-induced lung injury, inflammatory response, and the number of inflammatory cells in BALFs, as well as promoted cell viability and decreased inflammatory cytokine secretion. Collectively, our findings indicated that the NLRP3/caspase-1 pathway serves a vital role in the pathological changes of pulmonary inflammation caused by PM2.5 exposure. MCC950 was expected to be the therapeutic target of PM2.5 inhalation mediated inflammatory diseases.

Changes in Life Expectancy of Respiratory Diseases from Attaining Daily PM2.5 Standard in China: A Nationwide Observational Study

Although exposure to air pollution increases the risk of premature mortality and years of life lost (YLL), the effects of daily air quality improvement to the life expectancy of respiratory diseases remained unclear. We applied a generalized additive model (GAM) to assess the associations between daily PM_2.5 exposure and YLL from respiratory diseases in 96 Chinese cities during 2013–2016. We further estimated the avoidable YLL, potential gains in life expectancy, and the attributable fraction by assuming daily PM_2.5 concentration decrease to the air quality standards of China and World Health Organization. Regional and national results were generated by random-effects meta-analysis. A total of 861,494 total respiratory diseases and 586,962 chronic obstructive pulmonary disease (COPD) caused death from 96 Chinese cities were recorded during study period. Each 10 μg/m³ increase of PM_2.5 in 3-day moving average (lag02) was associated with 0.16 (95% CI: 0.08, 0.24) years increment in life expectancy from total respiratory diseases. The highest effect was observed in Southwest region with 0.42 (95% CI: 0.22, 0.62) years increase in life expectancy. By attaining the WHO's Air Quality Guidelines, we estimated that an average of 782.09 (95% CI: 438.29, 1125.89) YLLs caused by total respiratory death in each city could be avoided, which corresponded to 1.15% (95% CI: 0.67%, 1.64%) of the overall YLLs, and 0.12 (95% CI: 0.07, 0.17) years increment in life expectancy. The results of COPD were generally consistent with total respiratory diseases. Our findings indicate that reduction in daily PM_2.5 concentrations might lead to longer life expectancy from respiratory death.

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This is a nationwide time-series study in 96 Chinese cities

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PM_2.5 level was associated with increased risk of respiratory death

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PM_2.5 level was associated with increased years of life lost of respiratory death

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Daily PM_2.5 reduction might lead to longer life expectancy from respiratory death

Aerosol optical properties and its type classification based on multiyear joint observation campaign in north China plain megalopolis

Since haze and other air pollution are frequently seen in the North China Plain (NCP), detail information on aerosol optical and radiative properties and its type classification is demanded for the study of regional environmental pollution. Here, a multiyear ground-based synchronous sun photometer observation at seven sites on North China Plain megalopolis from 2013 to 2018 was conducted. First, the annual and seasonal variation of these characteristics as well as the intercomparsion were analyzed. Then the potential relationships between these properties with meteorological factors and the aerosol type classification were discussed. The results show: Particle volume exhibited a decreasing trend from the urban downtown to suburban and the rural region. The annual average aerosol optical depth at 440 nm (AOD440) varied from ∼0.43 to 0.86 over the NCP. Annual average single-scattering albedo at 440 nm (SSA440) varied from ∼0.89 to 0.93, indicating a moderate to slight absorption capacity. Average absorption aerosol optical depth at 440 nm (AAOD440) varied from ∼0.07 to 0.10. The absorption Ångström exponent (AAE) (∼0.89-1.40) indicated the multi-types of absorptive matters originated form nature and anthropogenic emission. The discussion of aerosol composition showed a smaller particle size of aerosol from biomass burning and/or fossil foil consumption with enhanced aerosol scattering and enlarged light extinction. Aerosol classification indicated a large percentage of mixed absorbing aerosol (∼20%-49%), which showed increasing trend between relative humidity (RH) with aerosol scattering and dust was an important environmental pollutant compared to southern China.

Study on the characteristics of black carbon during atmospheric pollution conditions in Beijing

Black carbon (BC), not only has a negative impact on human health, but also contributes to visibility degradation and the attenuation of solar radiation due to light absorption. In this paper, we investigated the variations of BC concentration, BC optical characteristics and its effects on the physical and optical properties of atmospheric aerosols based on AERONET data during atmospheric pollution conditions in Beijing from 2012 to 2017. The results indicated that the average annual ground-level BC concentration and BC/PM_2.5 were 8.9 μg m^-3 and 6.7%, respectively, from 2012 to 2017 during atmospheric pollution conditions in Beijing. The annual mean ground-level BC concentration showed weak variation, but the monthly variation was pronounced during atmospheric pollution conditions. Moreover, the BC column concentration had a higher correlation with absorptive aerosol optical thickness (AAOT) at 870 nm (R² = 0.93) than 440 nm (R² = 0.73). The difference in AAOT between 440 nm and 870 nm was more significant under high BC column concentration. The seasonal variation of the BC column concentration that contributed to the AAOT at 870 nm displayed a consistent monthly average variation tendency. The BC column concentrations were divided into three segments of low, moderate, and high according to the results of the approximately normal distribution of the BC column concentration. Compared with high BC concentration, the single scattering albedo (SSA) and asymmetry parameter were enhanced by 0.05 and 0.04 in low BC concentrations, respectively. On the contrary, the fine mode fraction (FMF) was dropped by 12.5% in low BC concentrations. A higher BC concentration contributed to the enhancement in the AAOT and the extinction ratio of the fine mode aerosol. Meanwhile, the atmospheric particles' forward scattering ability was also attenuated under a high BC concentration.

Characteristics of air pollutants inside and outside a primary school classroom in Beijing and respiratory health impact on children

This study investigated the spatial and temporal distributions of particulate and gaseous air pollutants in a primary school in Beijing and assessed their health impact on the children. The results show that air quality inside the classroom was greatly affected by the input of outdoor pollutants; high levels of pollution were observed during both the heating and nonheating periods and indicate that indoor and outdoor air pollution posed a threat to the children's health. Traffic sources near the primary school were the main contributors to indoor and outdoor pollutants during both periods. Moreover, air quality in this primary school was affected by coal combustion and atmospheric reactions during the heating and nonheating periods, respectively. Based on the estimation by exposure-response functions and the weighting of indoor and outdoor pollutants during different periods, the levels of PM_2.5, PM ₁₀ and O₃ at school had adverse respiratory health effects on children. Longer exposures during the nonheating period contributed to higher health risks. These results emphasized that emission sources nearby had a direct impact on air quality in school and children's respiratory health. Therefore, measures should be taken for double control on air pollution inside and outside the classroom to protect children from it.

Exhaled nitric oxide in ethnically diverse high-altitude native populations: A comparative study

OBJECTIVES

Andean and Tibetan high-altitude natives exhibit a high concentration of nitric oxide (NO) in the lungs, suggesting that NO plays an adaptive role in offsetting hypobaric hypoxia. We examined the exhaled NO concentration as well as partial pressure of several additional high-altitude native populations in order to examine the possibility that this putative adaptive trait, that is, high exhaled NO, is universal.

METHODS

We recruited two geographically diverse highland native populations, Tawang Monpa (TM), a Tibetan derived population in North-Eastern India (n = 95, sampled at an altitude of ~3,200 m), and Peruvian Quechua from the highland Andes (n = 412). The latter included three distinct subgroups defined as those residing at altitude (Q-HAR, n = 110, sampled at 4,338 m), those born and residing at sea-level (Q-BSL, n = 152), and those born at altitude but migrant to sea-level (Q-M, n = 150). In addition, we recruited a referent sample of lowland natives of European ancestry from Syracuse, New York. Fraction of exhaled NO concentrations were measured using a NIOX NIMO following the protocol of the manufacturer.

RESULTS

Partial pressure of exhaled nitric oxide (PENO) was significantly lower (p < .05) in both high-altitude resident groups (TM = 6.2 ± 0.5 nmHg and Q-HAR = 5.8 ± 0.5 nmHg), as compared to the groups measured at sea level (USA = 14.6 ± 0.7 nmHg, Q-BSL = 18.9 ± 1.6 nmHg, and Q-M = 19.2 ± 1.7 nmHg). PENO was not significantly different between TM and Q-HAR (p < .05).

CONCLUSION

In contrast to previous work, we found lower PENO in populations at altitude (compared to sea-level) and no difference in PENO between Tibetan and Andean highland native populations. These results do not support the hypothesis that high nitric oxide in human lungs is a universal adaptive mechanism of highland native populations to offset hypobaric hypoxia.

Comparison of PM2.5 emission rates and source profiles for traditional Chinese cooking styles

The number of restaurants is increasing rapidly in recent years, especially in urban cities with dense populations. Particulate matter emitted from commercial and residential cooking is a significant contributor to both indoor and outdoor aerosols. The PM_2.5 emission rates and source profiles are impacted by many factors (cooking method, food type, oil type, fuel type, additives, cooking styles, cooking temperature, source surface area, pan, and ventilation) discussed in previous studies. To determine which cooking activities are most influential on PM_2.5 emissions and work towards cleaner cooking, an experiment design based on multi-factor and level orthogonal tests was conducted in a laboratory that is specifically designed to resemble a professional restaurant kitchen. In this cooking test, four main parameters (the proportion of meat in ingredients, flavor, cooking technique, oil type) were chosen and five levels for each parameter were selected to build up 25 experimental dishes. Concentrations of PM_2.5 emission rates, organic carbon/elemental carbon (OC/EC), water-soluble ions, elements, and main organic species (PAHs, n-alkanes, alkanoic acids, fatty acids, dicarboxylic acids, polysaccharides, and sterols) were investigated across 25 cooking tests. The statistical significance of the data was analyzed by analysis of variance (ANOVA) with ranges calculated to determine the influence orders of the 4 parameters. The PM_2.5 emission rates of 25 experimental dishes ranged from 0.1 to 9.2 g/kg of ingredients. OC, EC, water-soluble ions (WSI), and elements accounted for 10.49-94.85%, 0-1.74%, 10.09-40.03%, and 0.04-3.93% of the total PM_2.5, respectively. Fatty acids, dicarboxylic acids, n-alkanes, alkanoic acids, and sterols were the most abundant organic species and accounted for 2.32-93.04%, 0.84-60.36%, 0-45.05%, and 0-25.42% of total PM_2.5, respectively. There was no significant difference between the 4 parameters on PM_2.5 emission rates, while a significant difference was found in WSI, elements, n-alkanes, and dicarboxylic acids according to ANOVA. Cooking technique was found to be the most influential factor for PM_2.5 source profiles, followed by the proportion of meat in ingredients and oil type which resulted in significant difference of 183.19, 185.14, and 115.08 g/kg of total PM_2.5 for dicarboxylic acids, n-alkanes, and WSI, respectively. Strong correlations were found among PM_2.5 and OC (r = 0.854), OC and sterols (r = 0.919), PAHs and n-alkanes (r = 0.850), alkanoic acids and fatty acids (r = 0.877), and many other species of PM_2.5.

Chemical composition and health risk indices associated with size-resolved particulate matter in Pearl River Delta (PRD) region, China

Size-resolved particulate matter (PM) was collected at the Heshan Super-Station in the Pearl River Delta (PRD) region, China, to evaluate their chemical characteristics and potential health risks. The chemical mass closures illustrate that the dominant fraction in coarse (2.5 μm < D_p < 10 μm) PM was dust, while organic matter made up a substantial portion of both fine (0.1 < D_p < 2.5 μm) and ultra-fine (D_p < 0.10 μm) PM fractions. The size distribution of most PM components varied substantially. PM, NO₃^-, K⁺, Cl^-, Na⁺ and most of the transition/redox metals displayed bimodal size distributions with the dominant peak at 0.32-0.56 μm plus a small peak at 1.8-3.2 μm. In contrast, unimodal size distributions were found for the rest of the species, such as water-soluble organic carbon (WSOC), NH₄⁺, and SO₄^2- and the majority of oxyanion metals with a single peak at 0.32-0.56 μm, and Mg²⁺, Ca²⁺, and dust tracer elements which mainly accumulated in coarse particles. Based on the crustal enrichment factor (CEF) analysis, Cd, Zn, Sb, Sn, As, Pb, Mo, Cu, and Cr primarily originated from anthropogenic activities, while Ti in all size fractions and Sr, Mg, Na, and Fe in fine and ultra-fine particles were mainly emitted from natural sources. The potential health risk assessment of trace metals was performed using the hazard quotient (HQ) and excess lifetime cancer risk (ELCR) indices. Although the adverse health effects of most metals were limited, significant potential carcinogenic risks were found for As and Cr in both fine and coarse particle size fractions, which contributed more than 95% of total ELCR. Therefore, considering that these two elements were mainly emitted from industrial processes, improvements in air quality and health risks in the PRD region can be largely achieved by reducing the emissions of local industrial sources.

Chemical characterization and source apportionment of PM2.5 personal exposure of two cohorts living in urban and suburban Beijing

In the study, personal PM_2.5 exposures and their source contributions were characterized for 159 subjects living in the Beijing Metropolitan area. The exposures and sources were examined as functions of residential location, season, vocation, cigarette smoking, and time spent outdoors. Sampling was performed for two categories of volunteers, guards and students, that lived in urban and suburban areas of Beijing. Samples were collected using portable PM_2.5 monitors during summer and winter. Exposure measurements were supplemented with a questionnaire that tracked personal activity and time spent in microenvironments that may have impacted exposures. Simultaneously, ambient PM_2.5 data were obtained from national network stations located at the Gucheng and Huairouzhen sites. These data were used as a comparison against the personal PM_2.5 exposures and produced poor correlations between personal and ambient PM_2.5. These results demonstrate that individual behavior strongly affects personal PM_2.5 exposure. Six primary sources of personal PM_2.5 exposure were determined using a positive matrix factorization (PMF) source apportionment model. These sources included Roadway Transport Source, Soil/Dust Source, Industrial/Combustion Source, Secondary Inorganic Source, Cd Source, and Household Heating Source. Averaged across all subjects and seasons, the highest source contribution was Secondary Inorganic Source (24.8% ± 32.6%, AVG ± STD), whereas the largest primary ambient source was determined to be Roadway Transport (20.9% ± 13.6%). Subjects were classified according to the questionnaire and were used to help understand the relationship between personal activity and source contribution to PM_2.5 exposure. In general, primary ambient sources showed only significant spatial and seasonal differences, while secondary sources differed significantly between populations with different personal behavior. In particular, Cd source was found to be related to smoking exposure and was the most unpredictable source, with significant differences between populations of different sites, vocations, smoking exposures, and outdoor time.

Chemical composition and source apportionment of ambient, household, and personal exposures to PM2.5 in communities using biomass stoves in rural China

Fine particulate matter (PM_2.5) has health effects that may depend on its sources and chemical composition. Few studies have quantified the composition of personal and area PM_2.5 in rural settings over the same time period. Yet, this information would shed important light on the sources influencing personal PM_2.5 exposures. This study investigated the sources and chemical composition of 40 personal exposure, 40 household, and 36 ambient PM_2.5 samples collected in the non-heating and heating seasons in rural southwestern China. Chemical analysis included black carbon (BC), water-soluble components (ions, organic carbon), elements, and organic tracers. Source apportionment was conducted using organic tracer concentrations in a Chemical Mass Balance model. Biomass burning was the largest identified PM_2.5 source contributor to household (average, SD: 48 ± 11%) and exposures (31 ± 6%) in both seasons, and ambient PM_2.5 in winter (20 ± 4%). Food cooking also contributed to household and personal PM, reaching approximately half of the biomass contributions. Secondary inorganic aerosol was the major identified source in summertime ambient PM_2.5 (32 ± 14%), but was present in all samples (summer: 10 ± 3% [household], 13 ± 6% [exposures]; winter: 18 ± 2% [ambient], 7 ± 2% [household], 8 ± 2% [exposures]). Dust concentrations and fractional contribution to total PM_2.5 were higher in summer exposure samples (7 ± 4%) than in ambient or household samples (6 ± 1% and 2 ± 1%, respectively). Indoor sources comprised up to one-fifth of ambient PM_2.5, and outdoor sources (vehicles, secondary aerosols) contributed up to 15% of household PM_2.5. While household sources were the main contributors to PM_2.5 exposures in terms of mass, inorganic components of personal exposures differed from household samples. Based on these findings, health-focused initiatives to reduce harmful PM_2.5 exposures may consider a coordinated approach to address both indoor and outdoor PM_2.5 source contributors.